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General NPI Number Information
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NPI Number | 1700705316
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Entity Type | Organization
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Legal Business Name | BRAIN BRIDGES LLC
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Dates
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Enumeration Date | 07/15/2026
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Last Update Date | 07/15/2026
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Provider Practice Location Address
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Address Line | 221 W LAKE LANSING RD
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City | EAST LANSING
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State | MI
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Zip | 48823-8661
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Country | US
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Telephone | 941-315-9290
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Fax |
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Provider Business Mailing Address
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Address Line | 3003 E MICHIGAN AVE # 1095
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City | LANSING
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State | MI
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Zip | 48912-4616
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Country | US
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Telephone | 941-315-9290
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Fax |
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Authorized Official
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Title or Position | LICENSED MASTER SOCIAL WORKER
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Name | ADRIAN KOENIG
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Credential | LMSW
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Telephone | 941-315-9290
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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